Graduated: 1984
NPI: 1700899721
Practice Locations (2)
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
1740 W TAYLOR ST
CHICAGO, IL 606127232
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
4440 W 95TH ST
OAK LAWN, IL 604532600
7086848000
Source: CMS National Downloadable File, September 2026.